Foot care is sometimes overlooked, yet foot pain in seniors, when it occurs, can be agonizing. Everything in our body ages. There is no downplaying that fact. There is however one organ that determines the level of mobility and independence of seniors and the elderly. This is the foot.
We generally tend to focus on the “big ticket” items that are first noticeable as we age – vision, hearing loss, mobility, changes in memory and cognitive health – and only start to worry about our feet when they begin to scream for attention.
This article focuses on reviewing the causes of foot pain in seniors and provides some simple remedies.
Understanding the Human Foot
To better address questions such as “What causes foot pain in the heel?, “What causes pain in the side of the foot?” and “What causes pain in the arch of the foot?” – among others, a brief overview of foot structure and function is necessary. This will help us understand pain “touch points” that may be experienced in the foot.
The human foot is subjected to extremely heavy use throughout life and it plays a crucial role carrying our body weight or other things we may carry. It is our only source of contact with the ground and aids mobility and balance.
When we walk, the foot adapts to uneven surfaces (sometimes experiencing minor trauma), contributes to shock absorption and helps to propel the body forward.
When there is foot pain, there may be difficulty walking, balance may be impaired, increased risk of falls could occur and there could be a loss of independence if untreated.
The human foot, though small, is a strong and complex “machine” made up of 26 bones, 33 joints and over a hundred muscles, tendons, and ligaments that work together to create motion.
The foot is subdivided into the hind foot, the mid foot, and the forefoot:
- The hindfoot is made up of the ankle bone) and the heel bone).
- The five irregular bones of the midfoot, form the arches of the foot which serve as a shock absorber. The mid foot is connected to the hind- and fore-foot by muscles
- The forefoot is made up of five toes and the corresponding five adjoining long bones forming the metatarsus.
- The instep is the arched part of the top of the foot between the toes and the ankle
Foot Pain In Seniors And Aging Feet
As feet grow older, they become less able to sustain the same level of “abuse” and activity we subjected them to when we were younger.
Due to weakening in the bones (See a previous article – https://metamorphosishub.com/what-is-the-process-of-aging-letstalk-mobility/), thinning of the skin, and wear and tear of the joints, the feet lose some of their strength.
The fatty pads underneath the foot which act as a shock absorber also become thinner, causing the feet to spread as we get older. This is the reason why shoe size and fitting slightly change with age.
Loss Of Muscle Mass And Weakness Of The Bones
There is a reduction in muscle strength, while bone weakness, in extreme cases, may become fragile (osteoporosis).
Skin Becomes Less Durable
The skin becomes thinner, its elasticity decreases, less fat is stored which reduces the cushioning effect, especially in the sole of the feet, causing it to be more sensitive to pain and prone to the formation of calluses. These factors also make the skin more vulnerable to injury taking longer to heal, while dry skin and cracked heels are common.
Decreased Elasticity Of The Tendons
The foot is less able to absorb impact because of the of reduced elasticity of the tendons that hold the arches together. The bones articulating at the joints wear with aging as they continuously rub against each other during motion, now making the feet less flexible
Poor Blood Circulation In The Feet
Poor circulation may be caused by a sedentary lifestyle common with many older people. It could also be caused by aging because of the stiffening and slight narrowing of blood vessels, obesity, smoking, diabetes and blood clots.
Symptoms of poor circulation in the feet such as increased swelling of the lower legs and feet, must be immediately reported to a doctor as they could be serious if left untreated.
Changes To The Toenails
Toenails usually become thicker and more brittle with age. Fungal infection of the toenails can also cause toenail thickening.
Causes of Foot Pain and Some Remedies
The major risk factors for developing foot pain are increasing age, higher frequency in women, poorly fitting footwear, obesity, depression and common chronic conditions such as diabetes and osteoarthritis. Menz (2016) identified that the most commonly reported foot problems by older people were corns and calluses, nail disorders and toe deformities.
Because of the tendency for dry skin, itching and burning sensations may occur. Using moisturizers with petroleum jelly or lanolin is helpful.
Wearing Improperly Fitting Footwear
In normally aging feet, the majority of foot pain is caused by poor footwear. While there are simply remedies that can be applied, if the condition persists, always consult your doctor.
Corns and Calluses
These are areas of hardened skin formed in reaction to the friction caused by wearing poorly fitted or tight shoes. Corns usually form on the top or side of the big or little toes, or on the top of the other toes.of the toes.
Calluses form on the surface of the bottom part of the foot. Anyone who has ever had them can testify as to how extremely painful they can be! Soaking the feet in warm water and carefully paring them down with a pumice stone may provide some relief. Consult your doctor for other safe methods of removal.
Are a bony protrusion at the base (side) of the big toe commonly caused by wearing shoes with a pointed forefoot or wearing high heels that force the toes too far forward in the shoes.
Wearing more appropriate footwear can correct this protrusion in its early stages. In more advanced stages, consult your doctor as surgery may be required.
The cause of heel spurs can be a muscle or ligament strain (or both) in the foot. Connecting the heel and ball of the foot is a long band of tissue, and when it gets stretched too much, heel spurs can result.
When this happens calcium deposits build up on the underside of the heel bone over a period of time.
Heel spurs can also appear when the membrane covering the heel bone is worn away by shoes that don’t fit correctly, putting too much pressure on the feet by being overweight or an imbalance in the way of walking.
Consult your doctor. Temporary relief can be provided by using additional support such as heel pads.
This is caused by wearing shoes that are too tight which squeeze on this enlarged nerve. This occurs more frequently in women than in men and can cause burning, tingling or numbness on the ball of the foot or even between the toes.
Wearing more comfortable shoes should rectify this but if it fails to do so, consult your doctor
These arise from wearing improperly sized shoes. When a toe does not have room to move, the knuckle can swell and draw the toe back. Hammertoes are especially troublesome for seniors because they can affect balance and increase the risk of falls. Remedy is to wear socks and shoes that allow ample space for the toes.
This is the inflammation of tissue in the band of tissue supporting the arch of the foot resulting in excruciating heel pain, It can be caused by wearing shoes with inadequate heel cushioning as well as by arthritis.
Occur when the corner or side of a toenail grows into the soft flesh of the toe (usually the big toe). It can cause a sharp or throbbing pain, swelling and redness of the toe. Regular careful trimming across of the nail to be even with the top of the toe usually helps to prevent future occurrence. If the ingrown toenail looks red and infected, consult the doctor
This is a fungal infection which loves warm, dark moist areas such as in your foot when it is housed in moist socks in shoes, It can be prevented by keeping the feet clean and dry, and occasionally airing the feet by wearing open-toe sandals.
There are several additional causes of foot pain induced by disorders like diabetes, osteoarthritis, rheumatoid arthritis and even congestive heart failure which can lead to nerve pain, weak and painful joints, and swollen feet. These disorders are discussed in a separate article.
General Protective Measures for Aging Feet
Take Calcium and Vitamin D for Bone Health.
The National Osteoporosis Foundation (NOF 2020) recommends:
- 1,000 mg of calcium daily for women aged 50 and younger and 1,200 mg for women aged 51 and older, while 1,000 mg of calcium is recommended for men aged 70 and younger, and, 1,200 mg for men aged 71 and older.
- For vitamin D which aids the body in calcium absorption, most adults under age 50 require 400-800 international units (IU) daily while most adults aged 50 and older need 800-1,000 IU daily.
- Always consult your doctor before taking supplements.
Wear Comfortable Shoes That Fit
These should be shoes which are not too stiff or rub against the feet making them sore. Socks and stockings should be the right size.
Pay Attention to Foot and Skin Care
Regular moisturizing, exfoliation of hardened skin, regular inspection and trimming of the nails are recommended.
Regular Exercise and a Healthy Diet
This will improve blood circulation to the feet
The majority of pain associated with aging feet experienced by seniors and the elderly are related to wearing incorrectly sized footwear. Foot spreading as we age means that shoe size must constantly be checked.
Seniors should avoid being overweight to prevent additional pressure on the feet causing further foot pain. Any underlying health issues should always be managed by a doctor.
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1. H. B.Menz (2016) Chronic foot pain in older people https://www.sciencedirect.com/science/article/pii/S0378512216301438
2. Elderly Foot Care (2020) https://www.afacc.net/foot-problems/treatment/geriatric-foot-care/
3. Foot Problems in the Elderly and Fall Risk (2020) https://www.visitingangels.com/knowledge-center/senior-health-and-well-being/foot-problems-in-the-elderly-and-fall-risk/486
4. M. Harding (2018) Ageing Feet. https://patient.info/senior-health/ageing-feet
5. C. Woolston (2019) https://consumer.healthday.com/encyclopedia/aging-1/misc-aging-news-10/foot-care-for-seniors-647577.html
6. What Causes Heel Spurs? (2020) https://www.drscholls.com/symptoms-and-conditions/foot/heel-spurs/